Newly diagnosed HIV infection – review in UK and Ireland

BMJ early online have published a case review of new HIV diagnoses in the UK and Ireland, looking at the occurrence of late diagnosis and associated features and to determine if patients had prior presentations that may have been related to HIV infection.

Data was collected via questionnaires, which were sent to adult HIV care providers in the UK and Ireland. Data on a total of 977 patients presenting with new diagnosis of HIV infection in January-March 2003 was collected.

A total of 301 patients (33%) presented late – this was more common in both older patients (adjusted odds ratio per increase in age group 1.68, 95% CI 1.42-1.98, p=0.0001) and in black Africans (1.66, 1.05-2.62, p=0.03). Overall, 401 (41%) were diagnosed via routine screening (e.g. sexual health, genitourinary or HIV clinic) – diagnosis in this way was associated with a lower chance of late diagnosis. A high proportion of patients (17%) sought medical care with symptoms in the preceeding 12 months but remained undiagnosed.

The authors conclude that this study provides further evidence of the late diagnosis of HIV infection, following national trends reported by the Health Protection Agency. They say that improving the offering and uptake of HIV testing both as part of routine screening and as indicated by associated medical conditions should reduce the number of undiagnosed infections.